New Pediatric Patients

We are excited that you have chosen us for your child's medical care. Your comfort and convenience are our priority, and we strive to make every visit to our office a positive experience. To help you get acquainted with our office and first visit procedures, we have included helpful information on this page.

Our Mission

Our practice is working together to build life-long relationships between our staff and our patients by consistently providing our patients with compassion, excellence and value. To fulfill this mission, we are committed to:

• Improving the lives of the children we serve by providing quality care in a child-centered environment.
• Listening to our young patients and their families who we are privileged to serve.
• Guiding our patients along a path of optimal health and wellness.
• Continually pursuing excellence at all levels through continuing education.

If you're preparing for your child's first visit, you can do a few things to help expedite the appointment. Please provide the following information when you arrive for your visit:

• Insurance cards
• Complete immunization records
• Medical records from your previous pediatrician

Patient Forms

We are happy to provide our office forms for convenient download on your home computer. Please print and complete the forms below, and bring them with you to your child's first appointment. Questions about which forms you need? Please call our office and our courteous staff will assist you in preparing for your child's first visit. Once we receive the signed form our records custodian will send the required form to your child's previous physician to request your child's medical records so we have complete and up to date information on your child to provide optimal care.

Clearwater Pediatric Care Forms

• Form to transfer records to our office
• Initial History Questionnaire
• HIPAA Consent Form
• New Patient Registration Form
• Office Financial Policy
• Notice of Privacy Practice (This is just for your information. You do not need to sign this or bring it to your visit)

Westchase Pediatric Care Forms

• New Patient Registration Form
• Notice of Privacy Practice
• Office Financial Policy
• Form to Transfer Records to Our Office
• HIPAA Consent Form
• Initial History Questionnaire

In order to view or print these forms you will need Adobe Acrobat Reader installed.
Click here to download it.

The Initial Visit

With all of the important information about our practice available on our website, you can feel confident that you and child are well-prepared for your first appointment. We also invite you to review our staff page in order to get to know our doctors and staff. We look forward to meeting you.

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